Math check for Homeopathic medicine please...

[Kizarvexis]

I've been hearing commercials on the radio here in Tampa for an ear ache drop called Similasan. The commercial mentions that Similasan is a homeopathic drug, which kicked off my alarm bells. When I found the website, Similasan is the name of the line of homeopathic 'drugs' marketed at Wal-Mart, Walgreens, Target, CVS/pharmacy, Rite Aid pharmacy, Eckerd, Safeway, Kroger, Albertsons, Longs Drugs, OscoDrug, Whole Foods Market and Wild Oats Natural Marketplace. Before I e-mail these companies, my local politicians and the Florida Department of Health, I wanted to run my math by you guys and gals to see if I did it right. (Anything copied from their website has only had the formatting changed for readibility in this post.)

http://www.healthyrelief.com/product...che-relief.cfm
On this page the Similasan Earache Relief, has the following active ingredients.

Drug Facts

Active Ingredients - Purpose
Chamomilla 10x - calmative, pain reliever
Mercurius solubilis 15x - anti-inflammatory
Sulphur 12x - pain reliever, anti-itch

Here is what they say about these ingredients.

Chamomilla is found in Similasan Earache Relief ear drops. Relieves ear pain while calming and soothing. Works especially well for patients who appear anxious and frantic, and who complain their ears feel clogged. (plant-based)

Sulphur (elemental sulphur) is found in Similasan Earache Relief ear drops. Indicated for pain, itching, and ringing in the ear. Elemental sulphur—a mineral found in nature—represents about 0.25% of the human body weight and is not considered allergenic. This ingredient should not be confused with common allergens such as sulfonamides and sulfites found in many prescription drugs and other products.

Mercurius Solubilis (also known as Quicksilver or Mercurius Vivus) is found in Similasan Earache Relief ear drops, and addresses inflammation and pain of the inner ear. This form of mercurius is non-toxic. Click here to read more information about homeopathic Mercurius solubilis. (Adobe Acrobat Reader required.)

The pdf on Mercurius Solubilis referred above, which should tip off people that this is not an effective cure.

Similasan Products & Diluted Mercury as Active Ingredient
Similasan Dry Eye Relief and Similasan Earache Relief do contain an extremely safe
microdilution of inorganic mercury.
- Homeopathic dosages are highly diluted and applied “topically”. The remedies are
not swallowed or inhaled, which are the primary means of toxic build up.
- Homeopathy is regulated by the FDA, unlike herbal products. This means these
Similasan products have been determined “safe and effective” by the FDA.
- Mercurius solubilis (found in Earache Relief @ 15X) Mercurius Sublimatus (found in
Dry Eye Relief @ 6X) are inorganic forms of mercury and the safest of the three
types of mercury, which are listed below:
- Inorganic (used in the two Similasan products) = least ability to cause
toxicity or build up, because it is poorly absorbed by human skin and
membranes.
- Organic = found in fish and can accumulate in the body. Usually spread in
the atmosphere by power plants. This ingestion or inhalation is the primary
cause of mercury poisoning in the U.S.
- Elemental Mercury = Slippery metallic material we see in thermometers.
Passes through the body if ingested.
- The inorganic mercury found in Similasan products is so miniscule that it would be
virtually impossible to build up to toxic levels in the body, even with regular use:
- You would have to apply 512 billion doses* of Similasan Earache Relief ear
drops to equal the amount of organic mercury in an average 4oz tuna steak.
- You would have to apply 857 doses** of Similasan Dry Eye Relief to equal
the amount of organic mercury found in an average 4oz tuna steak.
- Remember, the forms of mercury used in Similasan products is inorganic and
a highly diluted dose.
- Earache Relief inorganic mercury dosage = 0.0000000003 ppm. You’d have to
apply 6.4 billion doses* Similasan Earache Relief to equal the amount of mercury the
EPA allows in every 8oz glass of water.
- Dry Eye Relief inorganic mercury dosage = 0.224 ppm. You would need to apply
more than 10 doses** to equal the amount of mercury the EPA allows in every 8oz
glass of water.
- FDA’s allowable level of organic mercury in fish is 1.0 ppm
- NO KNOWN SIDE EFFECTS FOR ANY SIMILASAN PRODUCTS = SAFE AND
EFFECTIVE
* Assumes one dose = 5 drops in affected ear
** Assumes one dose = 2 drops in both eyes

This page, http://www.healthyrelief.com/hopw.cfm, gave me the information on what they mean by the 10x, 12x, and the 15x.

Similasan products stimulate the body to heal itself by utilizing "microdilutions" of the active ingredients. This system of medicine is know as homeopathy.


In the production of Similasan homeopathic medicines, all active ingredients (originating from mineral, plant or animal) undergo the process of serial dilution. The result is a microdiluted concentration of the ingredient, and its dilution level is often represented by an "X." For example, an ingredient diluted to the level of 6X contains 0.0000001% of the active ingredient—just enough to jump start the immune system. This homeopathic mode of action is similar in theory to a conventional allergy or flu shot, yet the active ingredients in homeopathic products are much more dilute, and are therefore safe for all ages without known side effects.

You may ask why the ingredients, such as apis (honey bee), belladonna and mercurius are used as active ingredients? After all, those substances can trigger various symptoms when used in heavy concentrations. This is true. In homeopathy, however, the dosages are not concentrated enough to poison the body. In fact, the dosage level is only enough to cause the body to detect the presence of the ingredient and then react to it. The body then reacts by triggering the immune system to heal the underlying problem. For example, a microdilution of honey bee will trigger the body to fight symptoms such as burning, stinging and swelling. In many cases, the cause of such symptoms is an allergy, therefore the ingredient apis (honey bee) is used to treat allergies.

In summary, homeopathy is a completely unique way of treating ailments. Rather than imposing a chemical drug on the body with the hope of temporarily masking symptoms, homeopathic active ingredients attempt to stimulate a physiological reaction of the body's healing mechanisms. In other words, homeopathy encourages the body to maintain proper health by imposing a gentle stimulus.

At Similasan, we call this "Healthy Relief via Active Response Formulas.®"

As I understand it, this is the standard homeopathic mantra.

Now, onto the math.

So if there is 10x Chamomilla, 12x Sulphur and 15x Mercurius solubilis, then the concentrations for a 10ml bottle of Similasan Earache Relief should be as follows;

10x Chamomilla = .0000000001 ml Chamomilla per 10 ml or 1x10^-10 ml or 100 picoliters per 10 ml

12x Sulphur = .000000000001 ml Sulphur per 10 ml or 1x10^-12 ml or 1 picoliter per 10 ml

15x Mercurius solubilis = .000000000000001 ml Mercurius solubilis per 10 ml or 1x10^-15 ml or 1 femtoliters per 10 ml

Now here is where I get fuzzy.

Dioxin has a LD50 of 20 micrograms/kilogram or 2x10^-7g/kg according to chemistry.org. (http://www.chemistry.org/portal/a/c/...6a17245d830100)

So would that be 2x10^-11g per gram? And could you use that as a comparison to the active ingredients above?

BTW, does anyone know how many atoms of Mercurius solubilis would even be in a femtoliter?

Kizarvexis

P.S. The FAQ for Similasan admits it doesn't work!! (Bolding and italics mine)

http://www.healthyrelief.com/faqs.cfm#a7

What if I choose the wrong product?

If you use the wrong remedy, it will not harm or help you. It will do nothing at all. To know which Similasan formula is best for you, choose the one that most closely matches your symptoms. Use for a period of time, and if relief is not evident, you may want to visit a physician.

[The Supreme Canuck]

I get 2x10^-10g/g.

But you'll want to wait for someone else to run the numbers, too.

[01101001]

Google Calculator: "20 micrograms/kilogram in g/g"

20 (micrograms / kilogram) = 2.0 × 10^-8 g / g

[The Supreme Canuck]

Wait, micrograms? Crud! I used grams. Indeed, it is 2.0 × 10^-8 g / g.

[SolusLupus]

I wish homeopathy were real. I only have to drink a milligram of coffee, and I'm infused with a caffeine rush.

[snarkophilus]

I wish homeopathy were real. I only have to drink a milligram of coffee, and I'm infused with a caffeine rush.

No... you'd have to drink a milligram of coffee diluted in several litres of water!

I'm glad it's not real. If every time someone dumped something in a river, the effects of that something were multiplied as it was diluted, we'd all be totally screwed. One drop of poison would become the ultimate weapon. (Or, if you're one of those people who says the reverse effect happens, then one drop of medicine would do it).

One of my favourite (sort of) papers of all time: "Transatlantic Transfer of Digitized Antigen Signal by Telephone Link," J. Benveniste, P. Jurgens, W. Hsueh and J. Aissa, Journal of Allergy and Clinical Immunology.

[Ken G]

I have no doubt at all that the company in question never puts any of those substances in its "medicines". It's just water. Why would they bother? The levels probably cannot even be tested for, and there's no one to test it anyway. There's no reason to be accurate, I'm sure they're not, but roughly speaking, 12X must come out in the ballpark of 10^-12 g/g. The real problem is, can you imagine the hassle it is to dilute something by 10^12 times? Note they really claim they dilute it, they don't say they just add a tiny amount to begin with (that wouldn't work, it seems). If you started with a teaspoon of solution, this would require almost a billion gallons of clean water to dilute that much. How much would that cost? It's completely ridiculous to think they are even going through the motions. They just bottle and sell water, and the natural concentrations of those "active" substances are probably higher than 12X anyway. Sulphur? Are you serious? Just how dumb to they think people are? Or a better question, just how dumb are they? Here's my product-- it's called placebowater. Works for every ailment, never a side effect. I can even undersell the homeopaths.

[Wolverine]

I wish homeopathy were real.

Same here. I'd save a fortune on beer.

[Dragon Star]

lol

[snarkophilus]

If you started with a teaspoon of solution, this would require almost a billion gallons of clean water to dilute that much.

I can see that you've never dated someone who was obsessed with homeopathic medicine. Gather round, children, and I will explain how it is all said to work.

Here is what you must do to create a good homeopathic medicine. First, obtain some of whatever causes the same symptoms you are suffering from. It doesn't even have to be exact -- if you have a headache, a crowbar will work as well as dollop of mercury (which apparently causes headaches). Actually, the crowbar isn't "natural," so depending upon your homeopath, you may be told that you're just being a jerk. To me, the crowbar seems like it causes more headaches than mercury does. *shrug*

Second, carefully measure out some amount of this substance. You may have to use an approved, precise measuring tool, like a 100 mL beaker. (If you've ever measured a solid in a beaker, then left it to settle for ten minutes, you will understand how ridiculous this idea is. Heck, if you've ever baked with brown sugar, or if you've ever looked at the standard error of your basic 100 mL-range beaker, you should understand this.) A mortar and pestle is a nice tool for grinding stuff, and if you have one you can charge more for your remedy.

Now, combine a precise amount of water and your ingredients in a flask. The water is best if it doesn't come from the tap. It should be as expensive as possible, preferably coming from a glacier or mountain spring. This is true even if the water from your tap has a lower mineral content than what is listed on the bottle. It's usually in the 100 mL range, but it depends on how much of the original ingredient you added. Sort of.

Shake. Apparently the way they teach you to shake stuff in university chemistry labs is not correct. The correct homeopathic method involves shaking the solution a precise number of times. There's also something to do with swirling or not swirling or something like that -- I apparently can't do it properly, although it was never explained to me why this is the case. The more edumacated of homeopaths will tell you that incorrect shaking disturbs the quantum memory structure of the water, or some babble like that. To be honest, it would not surprise me if you had to draw a circle starting with the north-most point, light some candles, and chant songs in a long-forgotten language as well.

Now, draw out 1 mL (or 10 mL, or whatever) of your mixture and put in a new flask. Dilute to 100 mL. Shake. Repeat a whole bunch of times, dumping most of what you used at each step. In this way, fifteen dilutions takes only 1.5 L of water.

Finally, sell at grossly inflated prices, or feed to your children/younger siblings instead of getting them actual antibiotics or influenza shots.

That is the process, children. Now, go spread the good word.

Just how dumb to they think people are?

Extremely dumb. As in it's a multi-billion dollar industry in North America, and their lobby groups are powerful enough to keep the fraud suits away.

Here's my product-- it's called placebowater. Works for every ailment, never a side effect. I can even undersell the homeopaths.

There's a Futurama episode that has one of the greatest moments in comedy. Bender is sick, and the dialogue goes something like this:
Amy: "You should try homeopathic medicine, Bender. Take some zinc."
Bender: "I'm 40% zinc."
Amy: "Then take some echinacea, or St. John’s Wort."
Professor Farnsworth: "Or a big fat placebo! It’s all the same crap!"

Oh, the hilarity.

Anyway, I am certain that with the right marketing, you actually could make a billion dollars with that idea. Of course, you would have to have no shred of moral fibre whatsoever to do so....

[JohnD]

I like the quote that homeopathic products are found to be “safe and effective” by the FDA. Safe, no doubt. Effective?
And as the Snark Lover explained homeopathy can't be discounted by toxic spills - unless of course they are shaken the the right way.

But think about the dilutions in a different way. I'll approximate, because accuracy doesn't matter. And assume, because I can't find a exact description of how Mercurius Solubilis is prepared.

Gm molecular wt of mercury=200gms
Homeopathic preparation starts with one drop of the original substance with 99 drops of water, or equivalent amounts. So as we are scientists (Yes?) let's assume that they put 1ml of elemental mercury in 99 mls water. And shake it.

1ml Hg = 13.5gms = (Avogadro's No.x 13.5)/200 atoms Hg = 0.4 x 10^21 atoms
or 4 x 10^20

"mercurius solubilis" is described as 15X, so has been diluted in this way 15 times, in other words x100^15, or x10^30
So in the final solution there are 4x10^(20-30) atoms of Hg.
=4^-10 atoms

We are discussing aliquots of 100 mls, so to make this meaningful, we need a larger number of aliquots, in fact 10^10, or 100mlx10^10
=1000 million litres

This will contain 4 atoms of mercury, so there will be one atom in 250 million litres of the homeopathic preparation.

This assumes, of course that elemental mercury dissolves completely in distilled water. Which it doesn't. And I won't bother to calculate the probability that the 5 drops (15 drops/ml) you put in your ear contain a mercury atom, because that doesn't matter to the homeopathist.

So we can be confident that FDA, who can do these sums as well as you or I, have got it right if they say that it is harmless. I'd love to see the evidence offered about 'effectiveness'.

Please check these calcs, someone!

John

PS 1000 million litres is a cubic kilometer.

[trinitree88]

PS 1000 million litres is a cubic kilometer.

Actually, a cubic kilometer is 1000m X 1000m X1000m, for 10⁹m³...and each m³ is 10dmX10dmX10dm...for 10³dm³. Each cubic dm is a liter. So, it's 10¹²liters...a trillion, not a billion, in a cubic kilometer.

[Relmuis]

"Mercurius solubilis" means "soluble mercury", a mercury compound which can be dissolved in water. A saturated solution would be Mercurius Solubilis 0, and extremely poisonous.

Homeopathic dilutions are derived from this by repeatedly diluting the solution with 9 times as much water (decimal or D dilutions), with 99 times as much water (centesimal or C dilutions) or with 999 times as much water (millesimal or M solutions). M2, C3 and D6 solutions, for example, would all contain 1 part pro million of the original 0 solution.

Whether there are still molecules in such a solution can be calculaterd if we remember that N grams of a substance with molecular mass N contains 6.02 times 10²³ molecules. (Avogadro's Constant.) Taking, for example, mercury disulfide, with molecular weight 265, and assuming that the original solution contains 0.265 grams per milliliter (I don't know the actual number), we get some 6 * 10²⁰ molecules per milliliter in the 0 sulution. So, one milliliter of the D20 dilution will still contain some molecules, but one milliliter of the D21 dilution might or might not contain a molecule, and one milliliter of a D30 (or C15 or M10) dilution will almost certainly contain no molecule at all. If Avogadro's Constant is correct, that is.

But a D10 solution would contain some sixty billion molecules, and might very well have some physical effect if ingested. (I would use it sparingly.) And I have myself witnessed the effect of sedative homeopathic medicine on a cat (during the New Year festivities some years ago). The cat was duly (even alarmingly) sedated, and I do not think that any form of placebo effect or autosuggestion can have been responsible, at the cat didn't know that she was being sedated; the stuff (not Mercurius solubilis, but something else) having been surreptitiously slipped into her food.

[Ken G]

This is a lot of good and more detailed information about homeopathic medicine. What I'm getting is that there is a lot of variance in what is even meant by the language used, like X15 dilution (is it D15 or one of the others?). Most importantly, there may be, or there may not be, a large number of atoms of the substance in question. So even the term "homeopathic" really has little meaning, you might be getting a total placebo, or you might actually be getting some powerful sedative (note that sometimes I think "homeopathic" and "herbal" are used almost synomymously, even though herbal remedies may of course contain active ingredients that could help or hurt you). And depending on the "active ingredient", you may certainly be getting more of it from your tap water (but it wouldn't really be all that "active", without the falderall.) So the real problem is not that it's all a placebo, because sometimes it may not be, the problem is there is no oversight or science or even agreement on vocabulary that is being applied. It's medicine as it was in the Dark Ages, or witch doctors. It leaves us to ask, which is worse, the snake oil version that is as pure as the water in your tap and is essentially a con like mediums or psychics, or the unregulated unknown concentrations in concoctions that actually do contain some active ingredient, which is like treating patients like guinea pigs and not even bothering to study the result of the experiment. Who is worse, someone who is well aware they are conning you and is only taking your money without harming your body, or someone who actually believes their own pretenses so could have a random effect on your health?

[Thomas(believer)]

Echinacea

[Halcyon Dayz]

Echinacea

That sounds clear-cut.

[The Supreme Canuck]

It's worse for ginsing. There are three varieties. One has an active ingredient that actually does some good. But the products you can buy are unregulated. So, you could get any of the three varieties. Also, even if you do get the right one, the concentration of the ingredient is unregulated. So, in a word, it's bunk.

I don't understand why people go for herbal medicine. I'd rather have the active ingredient (if there is one, and if it works better than any "artificial" substance) extracted, measured, tested, and then given to me.

[Ken G]

An interesting question left unanswered is, if echinacea is a pure placebo, then does alternative medicine channels provide a "better placebo" because of their emphasis on nurturing the patient psychology? Ideally, what you'd do is bring these better placebos, if they are that, under the aegis of science. In terms of the linked article, it doesn't say if the participants had any explanation of how echinacea is supposed to help you, which I suspect herbal providers generally do at length.

[RobA]

From the advertising blurb in the OP:

- Homeopathy is regulated by the FDA, unlike herbal products. This means these
Similasan products have been determined “safe and effective” by the FDA.

(my bold)

That claim might be worth looking into

[Metricyard]

What I find ironic, is that most of the "natural medicine" sold in the health stores are more then likely owned or subsidized by the large pharacutical companies.

Nothing like covering all the bases.

[snarkophilus]

It's worse for ginsing. There are three varieties. One has an active ingredient that actually does some good. But the products you can buy are unregulated. So, you could get any of the three varieties. Also, even if you do get the right one, the concentration of the ingredient is unregulated. So, in a word, it's bunk.

I don't understand why people go for herbal medicine. I'd rather have the active ingredient (if there is one, and if it works better than any "artificial" substance) extracted, measured, tested, and then given to me.

Oh, but ginseng is so tasty. Screw the imaginary health benefits -- follow your taste buds!

[The Supreme Canuck]

Hey, can't argue with that!

[JohnD]

Trinitree,
Thank you! Noughts always confuse me. Thats why the exponential notation was invented.

Thomas,
That NEJM paper used a straight plant extract. No homeopathic dilution technique, so no evidence that homeopathy is false. But good evidence that the extract doesn't work.

Relmius,
No argument with your calculations, just the interpretation.
"So, one milliliter of the D20 dilution will still contain some molecules"
Yes, 60 molecules. And D21, 6. D30? Can't be bothered.
But
"If Avogadro's Constant is correct, that is"
Please don't make throw-away comments like that. We are trying to have a rational conversation. Evidence, reference for this statement please?

Anyone who wnats to know, I found a detailed description of the dilution technique here: http://www.hpathy.com/pharmacy/potency-scales1.asp
Me, I'll stick to microgms/ml as a unit.

John

[grant hutchison]

I don't understand why people go for herbal medicine. I'd rather have the active ingredient (if there is one, and if it works better than any "artificial" substance) extracted, measured, tested, and then given to me.

Hear, hear.
I think the herbal remedy industry has done a very canny job of marketing, by implying that "natural substances" are somehow less toxic than "chemical drugs". It seems like a moment's reflection on that idea should turn up the obvious fallacies and errors, but very many people seem happy to accept it as an article of faith.

Grant Hutchison

[gwiz]

Anyone been watching the alternative medicine series on BBC TV? I missed the first programme on acupuncture, but the second on faith healing was fascinating stuff. They first established that it could be remarkably effective, then we saw a lot of experiments on the effectiveness of things like actors pretending to be healers and dummy (cut through skin and sew up again) surgery. The conclusion of all this is that if you think some process will cure you, then your brain releases dopamine which can indeed cure some conditions and reduces pain in others. In other words it put the placebo effect on a sound neurochemical basis.

[SolusLupus]

Hear, hear.
I think the herbal remedy industry has done a very canny job of marketing, by implying that "natural substances" are somehow less toxic than "chemical drugs". It seems like a moment's reflection on that idea should turn up the obvious fallacies and errors, but very many people seem happy to accept it as an article of faith.

Grant Hutchison

Y'know, there's a woman in my local SCA that swears by herbal remedies. I talked to her about chemical drugs, and she said some interesting things. One of the things she said was that she doesn't get why people assume that one trumps the other, or why you can have one but not the other.

In short, she wants a combination of chemical and natural remedies -- because, quite frankly, there ARE herbal remedies that work. Yes, there are plenty of quacks that sell you junk that don't, but if you do some cursory research, you can find natural substances that do various beneficial effects.

[grant hutchison]

... you can find natural substances that do various beneficial effects.

Sure. But then the lack of regulation comes into play. Do I really want to roll the dice on dosage every time I take such an active substance? No thanks. I'd rather someone extracted it, purified it and standardized the preparation. Unfortunately, this involves drug R&D costs and involves big pharma companies and all the complications they bring.

The relationship between herbal medicines and prescription drugs always strikes me as being analogous to that between hobbyists and professionals: I'm happy for a hobbyist to build a table for me, but not to service the brakes on my car. So I pay extra to have my brake work done by a certified professional. But everything about my personal physiology and biochemistry is as important to me as my brakes, so I'm always pushed towards the professionals. If I were messing with my brain chemistry, for instance, then I'd much rather go for a prescription drug in a standard dose with a standard side-effect profile, rather than an unpredictable hit of St John's Wort.

Grant Hutchison

[The Supreme Canuck]

Hear, hear.
I think the herbal remedy industry has done a very canny job of marketing, by implying that "natural substances" are somehow less toxic than "chemical drugs". It seems like a moment's reflection on that idea should turn up the obvious fallacies and errors, but very many people seem happy to accept it as an article of faith.

I just don't understand the distinction between artificial and natural. A chemical is a chemical, no matter where you get it from. Take organic food, for example. They fertilize it with manure and criticize others for fertilizing their crops with "artificial" chemicals. But they're getting the same chemicals from the manure! Not only that, but they also get bacteria not present in chemical fertilizer, like e. coli.

I don't get people.

[Nowhere Man]

Relmius,
..."If Avogadro's Constant is correct, that is"
Please don't make throw-away comments like that. We are trying to have a rational conversation. Evidence, reference for this statement please?

Avogadro's number has to be correct. It's in the definition. It's essentially the reciprocal of the atomic mass unit measured in grams. If there is any uncertainty, it's in the lesser significant digits.

If we used pounds instead of grams, it would be 2.73 * 10²⁶. Call this Avacado's Number .

Fred

[grant hutchison]

Take organic food, for example. They fertilize it with manure and criticize others for fertilizing their crops with "artificial" chemicals. But they're getting the same chemicals from the manure!

And the run-off from an over-manured field will cause the same algal overgrowth in river water that is seen with the overuse of "chemical" fertilizers.
Colin Tudge's book, So Shall We Reap, is an interesting and (apparently, to this ignoramus) balanced view of the advantages and disadvantages of various farming methods, if you're interested.

Grant Hutchison